The Continued Misadventures of Intentional C4 Ingestion: A Case Cluster

Several published case reports describe the intentional ingestion of cyclotrimethylenetrinitramine, more commonly referred to as Composite-4 (C4), by military personnel. This putty-like explosive material, used for breaching operations, can produce euphoric effects through polyisobutylene; however, the additional ingredient of Research Department Explosive (RDX), or "Cyclonite," can cause significant central nervous system disruption resulting in seizures. We report a unique case cluster of active-duty personnel with intentional C4 ingestion and wide-ranging symptoms, including seizures. Unit personnel discovered this cluster after progressive patient presentations. This report illustrates the spectrum of C4 ingestion effects, as well as the need for investigation to ensure prompt medical evaluation and management of those suspected of consumption.